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Screen time and study time: Internet addiction and academic performance in medical undergraduate students: A cross-sectional study
*Corresponding author: Rahul Singh, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India. singh.rahul.s@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Singh R, Pathak A, Yadav V, Singh M, Rana Y. Screen time and study time: Internet addiction and academic performance in medical undergraduate students: A cross-sectional study. Arch Biol Psychiatry. 2025;3:19-22. doi: 10.25259/ABP_8_2025
Abstract
Objectives:
Internet addiction (IA) has emerged as a significant behavioral concern, particularly among students who frequently rely on digital devices. Growing evidence suggests that excessive internet use may have a negative impact on academic performance. This study aimed to determine the prevalence of IA among medical undergraduates at a tertiary institute in rural Northern India and to evaluate its association with academic outcomes.
Material and Methods:
A cross-sectional analytical study was conducted over 18 months at a tertiary care institute in Sitapur, India. A total of 384 medical undergraduates (1st–4th year) were selected via convenient cluster sampling. Data were collected using a self-administered questionnaire comprising a semi-structured pro forma for demographics, the Young’s IA test to assess IA severity, and the Academic Performance Scale to measure academic functioning. Statistical analyses included descriptive statistics and Chi-square tests to explore associations between IA levels and academic performance.
Results:
Nearly half of the participants (49.0%) met criteria for IA, with 11.45% categorized as severe. Students with moderate-to-severe IA were significantly more likely to have poor or failing academic performance compared to those with normal or mild addiction levels (χ2 = 23.81, P < 0.001). A higher severity of IA was associated with an increased likelihood of poor or failing academic performance.
Conclusion:
This study identified a high prevalence of IA among medical undergraduates and a significant negative association between IA severity and academic performance. These findings highlight the need for awareness and preventive strategies to promote healthier digital habits among students.
Keywords
Academic performance
Cross-sectional study
Internet addiction
Medical undergraduates
Northern India
INTRODUCTION
The evolution of modern technology has profoundly reshaped human behavior, with mobile phones and digital devices becoming an integral part of daily life.[1] While these technologies have enhanced access to information and communication, their excessive use has been associated with several adverse health outcomes. Studies have linked prolonged screen time to an increased risk of metabolic syndrome,[2] migraine,[3] and psychological issues such as anxiety and depression among adolescents.[4,5]
Among young adults, including students, excessive Internet use has also been associated with impaired sleep patterns, unhealthy dietary habits, and reduced physical activity.[6] Medical students, in particular, face unique academic demands that require sustained concentration, self-discipline, and psychological resilience. However, the widespread and often uncontrolled use of the internet for academic, social, and recreational purposes may negatively impact their academic functioning.
Internet addiction (IA), characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access, has gained attention as a behavioral concern among students worldwide.[7] Existing studies indicate that medical students are particularly vulnerable to problematic internet use, which may contribute to poor sleep, emotional exhaustion, stress, and academic underperformance.[8,9] Despite a growing body of international literature, limited research has explored the prevalence and impact of IA among Indian medical undergraduate populations, especially in rural or semi-urban settings.
Given the critical importance of academic performance for medical undergraduates, understanding factors such as IA that may interfere with their academic success is imperative. This study aims to determine the prevalence of IA among medical undergraduate students at a tertiary institution in rural Northern India and to evaluate its association with their academic performance.
MATERIAL AND METHODS
Study design
A cross-sectional analytical study was conducted over 18 months at a tertiary care medical institute in Sitapur, India. Ethical clearance was obtained from the institutional ethics committee before the commencement of the study. The research aimed to determine the prevalence of IA among medical undergraduates and to assess its association with their academic performance.
Study participants
A total of 384 medical students, from first to fourth year, were recruited using convenient cluster sampling. Each academic year (1st–4th year) was treated as a distinct cluster. Convenience was operationalized based on students’ availability during lecture hours, willingness to participate, and consent rates. The sample size was calculated using Cochran’s formula (n = z2pq/e2), assuming a 50% estimated prevalence of IA, at a 95% confidence interval and 5% margin of error. Inclusion criteria comprised students enrolled for at least 6 months who provided informed written consent. Students with a known psychiatric illness, active substance abuse, or serious physical illness were excluded to avoid confounding effects.
Data collection
Eligible participants were informed about the study’s objectives, and written consent was obtained. Data were collected using a self-administered questionnaire available in English and Hindi, comprising:
A semi-structured pro forma for sociodemographic and personal details.
The young’s IA test (YIAT), a 20-item validated instrument designed to measure the severity of IA, was scored on a five-point Likert scale. The YIAT has demonstrated good internal consistency (Cronbach’s α = 0.89) and has been previously validated among Indian student populations.
The academic performance scale (APS), used to assess students’ academic functioning across domains such as academic focus, study habits, and examination outcomes. Although originally developed for broader educational settings, the APS has been widely utilized for evaluating academic outcomes.
Students’ academic records from institutional assessments were also accessed with appropriate confidentiality safeguards. Based on YIAT scores, IA severity was categorized as normal (0–30), mild (31–49), moderate (50–79), or severe (80–100). Academic performance was classified into five categories (excellent, good, moderate, poor, and failing) according to APS scores.
Statistical analysis
Data were coded, entered, and cleaned using Microsoft Excel, and then analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0. Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to summarize participant characteristics, YIAT scores, and APS scores. Chi-square tests were applied to assess associations between IA severity and academic performance. A P < 0.05 was considered statistically significant. All findings were summarized in tabular form for clarity.
RESULTS
Among 384 MBBS students, 27.3% exhibited moderate academic performance, followed by poor (23.4%) and good (19.5%) performance. Only 13.0% achieved an excellent rating, whereas 16.7% fell into the failing category [Table 1].
| Academic performance category | Frequency (n) | Percentage |
|---|---|---|
| Excellent | 50 | 13.0 |
| Good | 75 | 19.5 |
| Moderate | 105 | 27.3 |
| Poor | 90 | 23.4 |
| Failing | 64 | 16.7 |
MBBS: Bachelor of Medicine and Bachelor of Surgery; nrepresents number of students.
Approximately half (48.96%) of the participants reported varying degrees of IA. Moderate addiction was observed in 19.79% and severe addiction in 11.45% of the sample [Table 2].
| Internet addiction category | Frequency (n) | Percentage |
|---|---|---|
| Normal | 196 | 51.04 |
| Mild | 68 | 17.70 |
| Moderate | 76 | 19.79 |
| Severe | 44 | 11.45 |
MBBS: Bachelor of Medicine and Bachelor of Surgery; nrepresents number of students.
Statistical test
Chi-square value = 23.81, P < 0.001.
“Students with moderate-to-severe IA were significantly more likely to have poor or failing academic performance compared to those with normal or mild addiction levels (χ2 = 23.81, P < 0.001) [Table 3].”
| IA group | Good/Moderate/Excellent (n=310) | Poor/Failing (n=74) | Total (n=384) | Chi-square, P-value |
|---|---|---|---|---|
| Normal+Mild (n=264) | 230 | 34 | 264 | Chi-square=23.81, |
| P-value <0.001 | ||||
| Moderate+Severe (n=120) | 80 | 40 | 120 | |
| Total | 310 | 74 | 384 |
IA: Internet addiction; nrepresents number of students.
DISCUSSION
The present study identified a high prevalence of IA among medical undergraduate students, with 49.0% of participants meeting criteria for some level of addiction, including 19.79% with moderate and 11.45% with severe IA. These findings highlight that nearly half of the cohort may be vulnerable to problematic Internet use, which could adversely affect their academic performance and overall well-being.
The observed prevalence aligns closely with previous studies conducted among Indian medical students. Chaudhury et al.[10] found that 47% of students exhibited mild-to-severe IA, which disrupted their sleep cycles and academic activities. Sharma et al.[11] documented a 44% prevalence of moderate to severe IA, emphasizing associated outcomes such as emotional exhaustion, late-night Internet use, and declining academic scores.
The analysis showed a statistically significant negative association between moderate-to-severe IA and academic performance (χ2 = 23.81, P < 0.001). Students in this group were significantly more likely to perform poorly or fail academically. This supports prior findings by Pathak et al.[12] and Alimoradi et al.,[13] emphasizing that problematic internet usage – especially of moderate-to-severe intensity – correlates with academic underachievement.
International studies support this pattern. In a large-scale European meta-analysis, Alimoradi et al.[13] identified a strong association between IA and poor academic performance, compounded by disruptions in sleep and psychological well-being. Although prevalence rates vary across regions, the consistent association between problematic Internet use and scholastic underachievement underscores the global relevance of this issue.
Kuss and Lopez-Fernandez[14] emphasized that not all high-frequency internet users experience negative outcomes; students who use digital platforms in a purposeful and self-regulated manner may even enhance their academic productivity. These observations suggest that the nature of internet use – whether functional or compulsive – is critical in determining its impact on educational outcomes.
While the association between IA and academic performance is evident, it is important to interpret these findings cautiously. Other contributing factors, such as burnout, poor study habits, mental health challenges, or lack of time management skills, may also influence academic outcomes. Given the cross-sectional design, causal inferences cannot be drawn.
The consistency of our findings with both national and international literature indicates that IA among medical undergraduates is a significant concern. Addressing this issue may require institution-level interventions such as digital literacy programs, structured schedules, time-management workshops, and on-campus psychological support services.
Limitations
The study’s cross-sectional design limits the ability to establish temporality or causality. In addition, reliance on self-reported measures may introduce reporting biases. As the study was conducted at a single institution, the generalizability of the findings to other settings may be limited. Future multi-center and longitudinal studies could provide a more comprehensive understanding of the dynamics between internet use and academic performance.
CONCLUSION
This study revealed a high prevalence of IA among medical undergraduate students, with nearly half displaying some degree of problematic usage. A significant inverse association was found between IA severity and academic performance, with higher addiction levels corresponding to poorer academic outcomes. Although Internet access is integral to modern education, unregulated use may negatively impact academic achievement. The cross-sectional design and self-reported data limit causal interpretations, and the findings may not be fully generalizable beyond a single institutional setting. Nonetheless, the results emphasize the importance of recognizing and addressing IA among medical students to support their academic and professional development.
Ethical approval:
The study approved by the Institutional Human Ethics Committee at Hind Institute of Medical Sciences, Mau, Ataria, Sitapur, reference number: IHEC-HIMSA/MD/MS-22/RD-17/07-23, dated 17th July 2023.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript, and no images were manipulated using AI.
Financial support and sponsorship: Nil.
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